Minority rules on euthanasia
Last week, former prime minister Bob Hawke came out in favour of voluntary-assisted dying. The fact is that many attempts over the years have been made to pass a voluntary assisted dying law in Australia, but none has succeeded.
This is despite overwhelming public support (between 70 and 80 per cent) for the idea that terminally ill people who are suffering unbearably should be able to ask a doctor to help them end their life quickly and painlessly.
This level of support exists across all the survey categories of gender, age, religion and political allegiance.
Compassionate doctors in Australia already help suffering patients to die, but have to do so covertly.
Lengthy experience in Switzerland, Oregon, the Netherlands and Belgium demonstrates that legal safeguards have prevented exploitation of the vulnerable.
And the “dying with dignity” movement is growing, most recently in California, which last year passed a Death with Dignity law. Moreover last Thursday, the Trudeau government introduced similar legislation into parliament in Ottawa.
So why have Australian politicians not embraced a clear and compassionate vote-winner that has proven to be safe?
In Victoria, an upper house Parliamentary Committee is facing up to this question, and is looking thoroughly at end-of-life choices.
The committee’s composition is balanced, including three Liberals, three Labor members, a Green, and the leader of the Australian Sex Party Fiona Patten, who was instrumental in achieving agreement to set up the committee. As it happens, as party policy the Sex Party and the Greens both support voluntary assisted dying.
Since May 2015, the Victorian committee has held 17 public hearings and has received more than 1000 submissions. It has heard from doctors, nurses, palliative and aged care specialists, legal experts, ethicists, academics, religious bodies, community organisations and, crucially, from the dying themselves and their families and friends.
Before finalising its report on May 31 this year, the committee is currently studying the experience of voluntary assisted dying legislation in America and Europe.
A primary source of information for the committee, I suggest, is the Quebec Parliament, which passed an Act Respecting End-of-Life Care in 2014. This was based on a comprehensive report by a parliamentary committee, following lengthy consultation with local and overseas experts. Public support in Canada for medically assisted dying was over 75 per cent.
The Quebec Parliamentary Committee posed the question: “How should we respond to requests for help to die?”
Its conclusion was to propose “medical aid in dying”, because that “is consistent with the changes in our values, the law and medical practice”, because “palliative care cannot ease all physical and psychological suffering”, and because “allowing this practice would not harm society’s most vulnerable”.
The Victorian committee will also be addressing ethical values and overseas experience. I hope it will recognise that there is no set of universally acceptable ethics , even among members of the same religious faith.
For example, the Australian Catholic Bishops Conference argues that “killing” is wrong because the Church believes that there is an absolute value in every person’s life that takes precedence over personal autonomy. The bishops’ quote with approval the view that anyone who thinks their life is no longer worth living, even if they are suffering hopelessly, is “misguided”.
As with other religious institutions, when it comes to voluntary assisted dying the Catholic Church does not permit individual choice. Yet, currently, more than 70 per cent of Catholics actually support a voluntary assisted dying law. Their ethical values put them in direct opposition to their Church’s hierarchy.
They are in part represented by the organisation “Christians Supporting Choice For Voluntary Euthanasia”, which believes that “as a demonstration of love and compassion, those with a terminal or hopeless illness should have the option of a pain-free, peaceful and dignified death”.
That ethical values are subjective, not universally applicable, is also shown by the conflicting opinions of doctors.
The Australian Medical Association considers voluntary assisted dying to be inconsistent with what it sees as the role of doctors as healers. Similarly, the organisation “Doctors Opposed to Euthanasia” maintains that “the prohibition of intentional killing is a bedrock of both the law and medical ethics”.
On the other hand, there is a widespread view that the doctor’s role includes relief of suffering, even if that means the death of the patient. The equivalent in Quebec of the AMA is the College des medecins du Quebec which argues that “there are certain exceptional situations , uncontrollable pain or interminable suffering, for example , in which euthanasia could be considered to be a final step required to ensure provision of quality care”.
The Canadians acknowledge the reality that compassionate doctors do help suffering people to die, even though this is technically illegal. Similarly, Australian research has found that a third of the doctors surveyed had given dying patients more drugs than were necessary to relieve suffering, with the intention of hastening their death.
In its submission to the Victorian enquiry, the Australian Catholic Bishops said that “where euthanasia has been legalised, it has been disastrous for the vulnerable” and “the evidence from all places that have attempted to legalise and regulate euthanasia is that it is not possible to draft safeguards that would effectively protect vulnerable people from subtle or overt pressure to request euthanasia”.
This does not fit with the findings of the Quebec Parliamentary Committee which after a number of visits overseas, reported that “we did not observe any abuse associated with the feared slippery slope”. It quoted the Royal Dutch Medical Association: “The slippery slope has not materialised, i.e. euthanasia has not increased among people over age 80, the disabled, the chronically ill, the economically disadvantaged or other groups.”
The Committee noted “a handful” of technical breaches of the laws in the Netherlands and Belgium, where some formal procedures were not followed. However it observed that there had been no court cases, no media outrage and no diminution in popular or medical support for voluntary euthanasia.
All of the above makes me wonder if the Australian bishops and the Quebec Committee were looking at the same information!
In a secular society like ours, legislation should not be based on the view of the hierarchy of a particular religious organisation, but on hard evidence.
It is to be hoped that the Victorian Parliamentary committee’s recommendations will do precisely that.
Emeritus professor of history and politics at Griffith University, Ross Fitzgerald, is the author of 39 books, including the co-authored sexual/political satire ‘Going Out Backwards: A Grafton Everest Adventure’, published by Hybrid in Melbourne.
The Canberra Times, 18 April, 2016, CT2 p 4.